the perimenopause playbook

Women as YOUNG as their mid-30s are experiencing a CASCADE of SYMPTOMS like hot flashes and anxiety and are wondering WTF is up with their bodies. Nobody told them it could be PERIMENOPAUSE—arguably the most MISUNDERSTOOD phase of the MENOPAUSAL transition.

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Lindsay Welch knew something was up when she began waking in the middle of the night sweating, her body radiating a heat that made zero sense in San Francisco's chilly climate. The problem followed the 36-year-old when she moved to Austin, where her overheated body continued to fight sleep despite the constant blast of the air conditioner.

Throughout the day, her mind felt foggy, as if a thick cloud cover were obscuring her thoughts. She gained about 20 pounds in six months; meanwhile, her libido fell off a cliff. But what really drove her over the edge was her strangest symptom yet: a persistent itchiness in her ears. What started as an uncomfortable dryness progressed into an itch so strong that she fantasized about taking a wire brush to her ear canal. “It was insane,” says Welch, who's now 41. “There was no Q-tip strong enough.”

Again and again she described her symptoms to a variety of health care providers—general practitioners, ob-gyns. Maybe she just drank too much coffee, some of them suggested. Maybe she was depressed, others said.

Meanwhile, her symptoms intensified, like the volume on a stereo being turned up louder and louder until it’s impossible to ignore. At one point, she felt so low that she didn’t even want to get dressed in the morning. “You start to just be like, Well, maybe I really am depressed,” she says. “There was a gray filter on everything.”

Years passed this way, until she was 40 years old. As she continued to search for answers, she began receiving content on Instagram and TikTok about perimenopause. For Welch, the term was new, but the symptoms were all too familiar. She watched as her peers described what they were going through, and she thought, I have that, I have that, she says. “And it was just like, I'm not crazy.” She made an appointment at Midi Health, a telehealth clinic specializing in perimenopause and menopause care. There, the clinician confirmed that Welch was in perimenopause.